National Ayush Mission

Once upon a time India's health care system was dominated by Ayurveda- the holistic health approach to keep persons disease free by adopting healthy life style.
With so many attacks on Indian heritage Ayurveda was pushed back for centuries. Indian government never promote this health system as main health delivery tool.
Now Prime Minister Shri Narendra Modi launches a much needed mission to make Ayush as one of main health delivery system in India.
Here are salient features of National Ayush Mission

1. National Ayush Mission NAM An over view Dr. Surendra Chaudhary [email protected]

2. The much needed step

3. Every Ayurveda physician is eagerly waiting the details of National Ayush mission since the breaking news surfaced on 15 th September 2014. In this presentation I try to put the main features of the framework for implementation of the mission vision and objectives. Those who are aware/familiar with some of the schemes run by department of Ayush , GOI may find it as “Old wine in a New bottle ” Source-indianmedicine.nic.in Surendra Chaudhary

4. Brief summary The much needed government attention towards Ayush was fulfilled on 15 th Sept 2014 when union cabinet approved the National Ayush Mission under the chairmanship of Prime Minister. National Ayush Mission(NAM) will set up a National Mission as well as corresponding Missions in States and Union territories. Much emphasis was given to the North eastern states where Ayush services are at minimal level and three hill states-J&K, Himachal and Uttrakhand were treated with extra help. Mission will provide financial help to achieve the desired goal for all the four core strategies to make Ayush as main health care system of the country. Most of the schemes were already in place under Centre sponsored schemes by the department of Ayush . Some new components are included in all the streams- health services, educational institutions, drug standardization and medicinal plants. Monitoring and evaluation may be more effective after establishment of NAM There are some cosmetic changes like naming PIP(Program implementation Plan) to SAAP(State Annual Action Plan) with the same pattern.

5. Brief summary Two main intervention on the pattern of NRHM are being introduced by NAM are PMU(Program Management Unit) and HMIS(health Management Information System) Project Management Units will be set up at national and state level. All the recruitment will be on contractual pattern. Financial aid for Ayush services, education institutions and drug standardization will be in the following ratio- Center, state(other than NE&3Hill state- 75:25%-90:10% for medicinal plants NE&3Hill states- 90:10%- 100% for Medicinal Plants

6. Vision of NAM Improving AYUSH services to provide cost effective health care services Effort to make Ayush system as the main healthcare delivery system Improving Ayush institutes to produce quality graduates and post graduates Availability of the raw material for standard and quality AS&U medicine

7. NAM Objectives Providing cost effective Ayush services through upgrading existing Ayush dispensaries and hospitals Collocation of Ayush facilities at primary health centres, community health centres and district hospitals Institutional capacity building at state level by upgrading state pharmacies,drug testing facilities etc Supporting medicinal plants cultivation and adopting GAP(Good Agriculture Practices) to provide good quality raw material Providing marketing and development instructions for entrepreneurs and Setting up of warehouses and promotion of cluster cultivation

8. NAM Components Mandatory component Flexible component

9. A-Mandatory components Ayush Health care services Ayush educational services Quality control of ASU&H drugs Medicinal plants

10. B-Flexible component Ayush wellness centres Telemedicine Sports medicine Innovation in Ayush through PPP Interest subsidies components to private Ayush educational institutions Reimbursement of testing charges IEC materials R&D related to medicinal plants Project based voluntary certification schemes Market promotion, market Intelligence and buy back intervention Crop insurance for medicinal plants

11. Mission mechanism National level Mission directorate - National governing body Appraisal committee State level State Ayush mission society Governing body Executive body

12. National Mission Directorate National governing body

13. National Appraisal committee

14. State governing body

15. State Executive body

16. NAM Administrati ve Structure Mission directorate Appraisal committee State Governing body State Executive body Approval of SAAP based on recommendations of appraisal committee Appraising the SAAP,submit to the governing body Ayush system overview,review of Ayush policies&programme implementation,intersect oral coordination, approval is SAAP,exploration of measures to promote Ayush Review of expenditure & implementation of mission,preparation of state annual action plan(SAAP) Submit SAAP to governing body,execution of approved SAAP,monitoring & evaluation

17. Resources Human resources- All Human resource will be on contractual bases only Financial resources

18. Human Resources PMU S.N. Post Numbers National State UT NE 1 Program Manager 4 1 1 1 2 Sr. Consultants 9 N/A N/A N/A 3 Jr.Consultants 4 N/A N/A N/A 4 Finance Manager 4 1 N/A N/A 5 Accounts manager 4 1 N/A N/A 6 HIMIS manager 3 1 N/A 1 7 Monitoring & Evaluation consultants 2 N/A N/A N/A 8 Accountant 2 N/A N/A N/A 9 Data assistant 10 1 N/A N/A 10 Office assistant 2 N/A N/A N/A 11 Messenger / attendants 5 Consultants N/A 2 2 1

19. Component of NAM Core component- core or essential activities Flexible pool component- varieties of activities

20. Ayush Services Core or essential activities 1.Co-location of AYUSH facilities at PHCs, CHCs and DHs Establishment of AYUSH OPD Clinics in the Primary Health Centres Establishment of AYUSH IPDs in Community Health Centres (CHCs) Setting up of AYUSH Wings in District Hospitals

21. Ayush Services Core or essential activities 2. Supply of Essential Drugs to AYUSH Hospitals and Dispensaries 3. Up-gradation of exclusive/standalone Government AYUSH hospitals (other than PHCs/ CHCs/ DHs) 4.Upgradation of Government/ Panchayat / Government aided AYUSH Dispensaries 5.Setting up of up to 50 Bedded Integrated AYUSH Hospitals

22. Ayush Services Core or essential activities 6.Public Health Outreach activity* 7.Behavior Change Communication (BCC)* 8.Mobility Support* 9.AYUSH Gram* 10.School Health Programme through AYUSH* (*-Will discuss these issues later in this presentation)

23. Ayush Services Activities under Flexible Pool AYUSH Wellness Centres including Yoga & Naturopathy Tele-medicine Sports Medicine through AYUSH Innovations on Mainstreaming of AYUSH including PPP

24. Ayush Educational Institutions CORE ACTIVITIES Infrastructural development of AYUSH Under-Graduate Institutions Infrastructural development of AYUSH Post-Graduate Institutions/add on PG Pharmacy/Para-Medical Courses Setting up of new AYUSH educational Institutions in the States where it is not available in Government sector

25. Ayush Educational Institutions CORE ACTIVITIES Infrastructural developments includes the construction of OPD/IPD, teaching departments, library, laboratories, Hostel for girls and boys.

26. Ayush Educational Institutions FLEXIBLE ACTIVITIES Interest subsidy for Development of Private AYUSH Educational Institutions Private non-profitable educational institutions duly permitted by the Central Government for last five years under Indian Medicine Central Council (IMCC) Act 1970 and Homoeopathy Central Council Act, 1973 are eligible. Assistance will be given on a Detailed Project Report for up-gradation of the UG/PG Institution.

27. ASU&H Drugs Objectives To strengthen State Govt. ASU&H Pharmacies and Drug Testing Laboratories Strengthening of ASU&H regulatory framework. To improve the Quality of ASU&H Drugs to enable their export in International Markets.

28. ASU&H Drugs Core Component Grant in aid to State/Govt. ASU&H Pharmacies/ State Govt. ASU&HCooperatives , State Govt. ASU&H PSU’s. Grant in aid to State Drug Testing Laboratories of Ayurveda, Siddha , Unani and Homoeopathy (ASU&H) Drugs. Grant-in-aid for strengthening of ASU&H Drug Control Framework. Grant in aid to State Licensing Authority of ASU&H Drugs for documentation publication and dissemination of quality control material for States.

29. ASU&H Drugs Core Component It is for strengthening of existing manufacturing units in the form of grant for upgrading of equipments, reagents & chemicals and building, drug testing facilities including man power Setting up of new manufacturing units in state and cooperative sectors

30. ASU&H Drugs Flexible Component IEC materials

31. Medicinal Plants Medicinal Plant Board Development and cultivation of medicinal plants under the CentrallySponsored Scheme of National AYUSH Mission Good Agriculture Practices (GAP), Good Collection Practices (GCP), and Good Storage Practices (GSP). Support Cultivation of Medicinal Plants Establishment of Seed / germ plasm Centers and nurseries for Supply of Quality Planting Material Model Nurseries, Small Nurseries

32. Medicinal Plants Support for Medicinal Plant Processing and Post Harvest Management including Marketing- Drying yards, Storage godowns , Processing unit ,Quality testing of raw material Marketing- Market Promotion, Market Intelligence, Buy – back Interventions:-

33. Medicinal Plants Quality testing, certification and insurance Quality Testing Certification Crop Insurance

34. MEDICINAL PLANT PROCESSING CLUSTERS Each of the cluster development projects including collection cluster implemented by a Special Purpose Vehicle (SPV) for medicinal plants processing units in a cluster shall be eligible for funding under the scheme upto 60% of cost of the core interventions, 25% of the cost of add on interventions, within overall ambit of 60% of the project cost subject to maximum of Rs. 10.00 crore per cluster. The assistance is further subject to the following: 1.Assistance for engagement of CDEs and other management support of SPV shall not exceed 5% of the overall project cost. 2.Assistance for engaging engineers / architects / construction management / other experts for execution of civil works shall not exceed 5% of the overall project cost. Continued………

35. MEDICINAL PLANT PROCESSING CLUSTERS 2.Assistance for engaging engineers / architects / construction management / other experts for execution of civil works shall not exceed 5% of the overall project cost. a) Project cost for the purpose of the scheme shall mean the total cost of proposed interventions. b)The scheme would be modular in nature with a provision to add interventions o the approved project DPR while implementation is on. The addition however, hould be in conformity to the overall project and the scheme objectives and subject to approval by Standing Finance Committee (SFC) c) SPVs may dovetail funds from other sources as well for the project, provided there is no duplication of funding for the same component / intervention. However, in cases of such dovetailing, it shall be ensured that the contribution of the participating units of SPV is at least 10% of the overall project cost.

36. Salient new features of Ayush health care services under National Ayush Mission

37. Public Health Outreach activity To reduce the incidence of the disease burden of communicable or non-communicable or both as the case may be in selected geographical area during specific period of time . To have public awareness about the importance of hygiene, dietary habits, prevention, promotion etc. through AYUSH systems of medicine in the area. To establish a Community Based Surveillance System (CBSS) for early identification of the outbreak. To increase the accessibility of AYUSH treatment of the population residing in the particular geographical region.

38. Public Health Outreach activity Formulation of specific module for the activities at that geographical region. The unit size of the implementation will be 2 blocks . Formulation and training of Health Education team Medical camps Peripheral OPDs

39. Public Health Outreach activity Formulation and training of Health Education team Health team comprising of health professionals, teachers, public health activists etc Community intervention through behavioral change communication techniques, regular health education classes,

40. BCC & Mobility support The disease burden of the country is shifting towards communicable diseases to non- communicable diseases. Early prevention and case detection is the most important strategy of all non-communicable diseases which are generally emerged due to life style deviations and ill-healthy diet. AYUSH systems of medicines are thrived in the country with well-founded principles of disease prevention, promotion of health and specific intervention considering patient and environmental and dietary factors. Mass media communication strategy incorporating AYUSH strengths in early prevention of diseases through promotion of healthy diet and life style to be adopted by the community will be advocated by the states for which adequate financial support is proposed to be provided under AYUSH flexipool . Mobility suppor t-Successful generation of outcome envisaged under the mission can only be resulted by regular and systematic monitoring. Therefore, provision has been made for financial assistance for limited mobility support to the State and District functionaries for conducting essential monitoring activities.

41. Ayush Gram AYUSH Gram is a concept wherein one village per block will be selected for adoption of method and practice of AYUSH way of life and interventions of health care. In AYUSH village AYUSH based lifestyles are promoted through behavioural change communication, training of village health workers towards identification and use of local medicinal herbs and provision of AYUSH health services. The elected village representatives are sensitized towards the concept so that there is also active participation from the community. Objectives: To spread awareness within community for practice of those dietary habits and life styles as described in AYUSH Systems of Medicine which help in preventing disease and promoting health. To advice people for preservation and cultivation of those herbs which are found in their surroundings by explaining them their medicinal values. To advice people about common ailments and its cure thorough use of herbs found in their localities. To raise campaign against communicable diseases like Malaria, T.B., Diarrhea etc. and measures for their prevention and treatment.

42. Ayush Gram The AYUSH Medical Officers under the programme implement the health plans and train the health workers in identification of medicinal plants and utilization of home remedies. The health workers keep the record of health status and health register of village and provide information regarding health related issues of the wards in village. He/She will also identify the medicinal herbs in the area to ensure its utilization, and protection. The members from Medicinal Plants Board will motivate the farmers to cultivate medicinal herbs and provide necessary information and assistance for cultivation of medicinal plants. The Self Help Groups involved in the programme will manufacture herbal preparations as home-remedies and with the help of health worker motivate villagers to utilize it for different health problems. Traditional healers of the village may also be involved in identification of medicinal plants and their use as home-remedies. Organizing Yoga camps and participating in National Health Programs, medical camps, anti-natal check ups.

43. School Health Programme through AYUSH AYUSH Health and Nutrition education Education on home remedies and locally available medicinal plants and importance of growing medicinal plants in home gardens. Practice of Yoga, Education on sexual and reproductive health issues Health screening:- Early detection and management of common problems e.g ;- visual and hearing problems, physical disabilities, common skin problems, learning disabilities etc. Nutrition, anaemia, worm infestation management, Development and dissemination, Referral linkages with health services and local remedial action. Referral linkages with AYUSH Medical colleges or AYUSH Hospitals for remedial and preventive measures may also b e undertaken. Nodal teachers for AYUSH School Health programme should be identified

44. [email protected] Thanks